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[Ping An]: This chapter, from the beginning to the end, is found in *Ling Shu* (Spiritual Pivot), Volume 5, Chapter 28, "Kou Wen" (Questions of the Mouth). Additionally, from "Huang Di said: What qi causes a person to yawn?" to the end, it is found in *Jia Yi Jing* (The Classic of A-Bio Points), Volume 12, Chapter 1, with only slight differences in arrangement.

When Huang Di was resting in leisure, he dismissed his attendants and asked Qi Bo: "I have heard the classics on Nine Needles, having completed the discussion on Yin-Yang, reversals and順sequences, and the Six Meridians. I now wish to hear about 'Kou Wen' (inquiries based on oral symptoms)." Qi Bo stepped down from his mat, bowed twice, and replied: "What an excellent question! This is the secret orally transmitted by our former masters. (Note: Jian ju means resting in leisure; bi means to dismiss; Liu Jing refers to the three Yin and three Yang meridians of both Yin and Yang; Kou chuan means that written texts provide only the general outline, while oral transmission conveys the subtleties, i.e., explaining the principles verbally.) [Ping An]: In *Ling Shu*, 'bi zuo you' is written as 'pi zuo you', 'yi wen' as 'yi wen', and there is no 'dui' character after 'zai bai'."

Huang Di said: "I wish to hear this oral transmission." Qi Bo said: "The onset of all diseases arises from wind, rain, cold, and heat; imbalances in Yin-Yang and emotions such as joy and anger; improper diet, drinking, and living habits; and sudden fright or terror. (Note: Wind, rain, cold, heat, and improper living habits are external pathogens; imbalances in Yin-Yang, emotions, diet, and fright/terror are internal pathogens.) [Ping An]: Yuan edition writes 'yuan wen' as 'yuan wen'. Shi yin in *Ling Shu* is written as 'yin shi'.) This leads to the separation of Blood and Qi, (This is the cause of disease from internal and external pathogens, having five distinctions. One, causing Blood and Qi to not merge.) the disintegration of Yin and Yang, (Two, causing the Yin and Yang of Zang-Fu organs to scatter.) the severance of Collaterals and Meridians, and the blockage of Pulse pathways, (Three, causing the Main Meridians and various Luo Collaterals to be disconnected. [Ping An]: In *Ling Shu*, 'jue' is written as 'jue'.) the reversal of Yin and Yang, and the stagnation of Wei Qi (Defensive Qi), (Four, causing the Qi of Yin and Yang to be discordant and Wei Qi to fail to circulate.) the emptiness of Meridians, and the disorderly flow of Blood and Qi, thereby losing their normal state, (Five, causing the exhaustion of all Meridians and Collaterals, and the irregular circulation of Ying (Nutritive) and Wei Qi. [Ping An]: In *Ling Shu*, 'kong xu' is written as 'xu kong'.) For those discussions not covered in the classics, please allow me to explain their treatment methods. (As mentioned above regarding what is in the classics, I already know it. For illnesses not discussed in the classics, please let me explain their methods.)

Huang Di said: "What qi causes a person to yawn?" Qi Bo said: "Wei Qi (Defensive Qi) travels through the Yang aspects during the day and through the Yin aspects at night. Yin governs the night, and the night governs sleep. Yang governs the upper part, and Yin governs the lower part. Therefore, when Yin Qi accumulates in the lower part and Yang Qi has not yet exhausted, Yang pulls upward and Yin pulls downward. The mutual pulling of Yin and Yang results in frequent yawning. When Yang Qi exhausts and Yin Qi becomes abundant, the eyes close (sleep); when Yin Qi exhausts and Yang Qi becomes abundant, one awakens. (Note: Yang Qi governs the day and is upper; Yin Qi governs the night and is lower. When Yin exhausts and Yang is abundant, one wakes; when Yang exhausts and Yin is abundant, one sleeps. Now, since Yang Qi is not yet exhausted, it pulls Yin upward; since Yin Qi has risen, it pulls Yang downward. The mutual pulling of Yin and Yang up and down causes frequent yawning. [Ping An]: In *Jia Yi*, there is no 'ri' character after 'zhou', and no 'ze' character in 'ye ze xing yu yin'. In *Ling Shu*, there is a 'ban' character after 'ye'. Also, in *Jia Yi*, 'yang yin' is written as 'yang qi', 'yin yin' as 'yin xing', and there are three characters 'shen zhu qian' after 'ze wu'.) Treatment should involve reducing the Foot Shaoyin (Kidney) meridian and supplementing the Foot Taiyang (Bladder) meridian. (Reduce the excess in the Foot Shaoyin Kidney meridian and tonify the deficiency in the Foot Taiyang Bladder meridian to harmonize Yin and Yang Qi, thus curing the yawning. Some versions read Foot Taiyin.)

Huang Di said: "What qi causes hiccups (yue)?" Qi Bo said: "Food enters the Stomach, and Stomach Qi ascends to the Lung. However, if old Cold Qi and new Grain Qi enter the Stomach together, the new and old mix chaotically, the True Qi and Pathogenic Qi attack each other and reverse, rebounding in the Stomach, thus causing hiccups. (Note: After food enters the Stomach, clear Qi ascends to the Lung, and turbid Qi remains below in the Stomach. If old Cold Qi and new Grain Qi enter together, the new and old True and Pathogenic factors attack and reverse in the Stomach, then exit from the Stomach, thus causing hiccups. [Ping An]: In 'bing xiang ni', *Ling Shu* adds 'qi' before 'bing', while *Jia Yi* omits 'bing'. In 'fu yu wei', *Ling Shu* and *Jia Yi* add 'chu' after 'fu'.) Treatment should involve supplementing the Hand Taiyin (Lung) meridian and reducing the Foot Shaoyin (Kidney) meridian. (It is appropriate to tonify the Lung meridian Hand Taiyin and reduce the Kidney meridian Foot Shaoyin. Since Foot Shaoyin governs Cold, it must be reduced; Hand Taiyin governs Qi, so it is supplemented first. [Ping An]: *Jia Yi* adds 'fei zhu yue' before 'bu', changes 'foot shaoyin' to 'foot taiyin', and adds twenty-four characters: 'One can also prick the nose with grass until sneezing occurs; hold breath and pull quickly, and it stops immediately; shocking the patient greatly can also cure it.')

Huang Di said: "What qi causes sobbing (xi)?" Qi Bo said: "This is due to abundant Yin Qi and deficient Yang Qi, where Yin Qi moves rapidly and Yang Qi moves slowly. With abundant Yin Qi and exhausted Yang Qi, sobbing occurs. (Note: Xi sounds like 'huo ji fan', meaning laugh. Abundant Yin Qi moves rapidly, deficient Yang Qi moves slowly, hence exhausted Yang Qi causes sobbing.) Treatment should involve supplementing the Foot Taiyang (Bladder) meridian and reducing the Foot Shaoyin (Kidney) meridian. (Since the Bladder Taiyang Fu organ's Qi is exhausted, it must be supplemented. Since the Kidney Shaoyin Qi is abundant, it must be reduced.)

Huang Di said: "What qi causes shivering and coldness (zhen han)?" Qi Bo said: "Cold Qi lodges in the skin, Yin Qi is abundant, and Yang Qi is deficient, thus causing shivering and coldness. Treatment should involve supplementing all Yang meridians. (Because Yang is deficient and Yin is abundant, Yang deficiency makes the skin vulnerable, and Yin abundance allows Cold to lodge in the skin, causing shivering and coldness; thus, the Three Yang meridians should be supplemented.)

Huang Di said: "What qi causes belching (yi)?" Qi Bo said: "Cold Qi lodges in the Stomach, Jue Ni (Rebellious Qi) rises from below and scatters, then re-emerges from the Stomach, thus causing belching. (Note: Cold Qi first lodges in the Stomach, becomes rebellious and rises upward to dissipate, then re-emerges from the Stomach, thus causing belching.) Treatment should involve supplementing the Foot Taiyin (Spleen) and Foot Yangming (Stomach) meridians, or alternatively, supplementing the Meiben point. (The Spleen and Stomach Zang-Fu organs are both deficient, so these two meridians are supplemented. Meiben is the Cuanzhu point at the inner end of the eyebrow, where the Foot Taiyang meridian Qi emerges.)

Huang Di said: "What qi causes sneezing (ti)?" Qi Bo said: "When Yang Qi is harmonious and smooth, filling the Heart and emerging from the Nose, sneezing occurs. (Note: Harmonious and smooth Yang Qi fills the Heart, rushes upward, and emerges from the Nose, thus causing sneezing.) Treatment should involve supplementing the Ying (Spring) point of the Foot Taiyang meridian and the Meiben point, or alternatively, the area above the eyebrows. (Yang is deficient but smooth, so the Yang meridian is supplemented. The Taiyang meridian begins beside the nose and emerges at Cuanzhu. The Taiyang Ying point is at Tonggu, located in the depression proximal to the metatarsophalangeal joint on the lateral side of the foot.)

Huang Di said: "What qi causes physical laxity and weakness (dan)?" Qi Bo said: "If Stomach Qi is not solid, the pulses become deficient; if the pulses are deficient, muscles and sinews become flaccid and lazy. If one exerts effort in sexual intercourse while muscles and sinews are flaccid, Qi cannot recover, thus causing physical laxity. (Note: Stomach Qi is not solid, meaning Grain Qi is scarce. Since Grain Qi is scarce, the pulses and muscles/sinews become deficient and flaccid. Therefore, engaging in sexual activity (xing yin) occurs. Engaging in sexual activity with exertion prevents Qi recovery, leading to flaccidity of the four limbs, hence named Dan. Dan, pronounced 'yun gan fan', means traction/pulling, referring to body laxity and inability to retract. [Ping An]: In *Ling Shu*, Dan is written as '𢻮', pronounced 'tuo', meaning drooping. In *Jia Yi*, it is written as '𢻮', which is a corruption of '𢻮'. The Yuan edition omits 'zhu mai xu' three times after 'zhu mai xu', and the note 'gu qi shao' is mistakenly written as 'gu shao qi'.) Treatment should involve supplementing the space between the muscles. (Since sinews and pulses are deficient, the affected intermuscular spaces are supplemented.)

Huang Di said: "What qi causes weeping and tearing due to sorrow? (Note: Excessive tearing and crying lead to loss of vision; what qi causes this?)" Qi Bo said: "The Heart is the master of the Five Zang and Six Fu organs. (Note: There are three reasons for tearing/crying. The Heart governs Spirit use and is the master of Zang-Fu, which is one. ) The Eyes are the gathering place of the Zong Mai (Major Meridians) and the pathway for Upper Fluids. (Note: The six Yang meridians of Hand and Foot, along with Hand Shaoyin and Foot Jueyin, converge at the eyes, hence called the gathering of Zong Mai. Urination and defecation are the pathways for Lower Fluids, while tearing and crying are the pathways for Upper Fluids, which is two. [Ping An]: The note 'yi wei shang ye zhi dao' in the Yuan edition omits the character 'yi'.) The Mouth and Nose are the portals of Qi. (Note: The Eyes are solely a pathway for fluids; the Mouth and Nose are pathways for both Qi and fluids, which is three.) Therefore, sorrow, grief, and worry move the Heart; when the Heart moves, the Five Zang and Six Fu organs all tremble; when they tremble, the Zong Mai become abundant; when Zong Mai are abundant, the fluid pathways open; when fluid pathways open, tears and saliva flow out. (Note: When something becomes abundant, the Heart moves; because the Heart moves, the Heart and the other four Zang organs plus the Six Fu organs all tremble; once Zang-Fu tremble, their meridians all move; when the Zong Mai of Zang-Fu tremble, the fluid pathways of the Eyes and Nose open; because fluid pathways open, tears and saliva flow out. [Ping An]: In 'zong mai sheng', *Ling Shu* and *Jia Yi* write 'sheng' as 'gan'. Also, in the note 'you wu xiang sheng', 'sheng' is suspected to be a transcription error for 'gan'.) Body Fluids are used to nourish Essence and moisten the empty orifices. Therefore, when the Upper Fluid pathway opens and crying does not stop, Body Fluids are depleted; when Body Fluids are depleted, Essence is not nourished; when Essence is not nourished, the eyes lose vision, hence it is called 'Duo Jing' (Depletion of Essence). (Note: Grain fluids nourish the eyes, and Grain Essence moistens the seven orifices; now, if they continuously exit from the Eyes and Nose, they are depleted. Without Body Fluids, Essence is lost, so the eyes have no Essence and cannot see, hence Depletion of Essence. [Ping An]: In 'qi chu bu zhi', *Ling Shu* and *Jia Yi* write 'ze qi, qi bu zhi'.) Treatment should involve supplementing the Tian Zhu Jing (Heavenly Pillar Meridian) alongside the Neck. (Tian Zhu Jing refers to the Foot Taiyang meridian. Tian Zhu is located in the depression lateral to the large tendon behind the neck at the hairline, where Foot Taiyang meridian Qi emerges, so it is supplemented. [Ping An]: In *Ling Shu* and *Jia Yi*, 'xiang' is written as 'jing'. *Jia Yi* adds seven characters after 'jing': 'xia jing zhe, tou zhong fen ye'. This book places them later.)

Huang Di said: "What qi causes deep sighing (tai xi)?" Qi Bo said: "Worry and thought tighten the Xin Xi (Heart Connection); when the Heart Connection is tight, the Qi pathway is constrained; when the Qi pathway is constrained, it is obstructed, thus causing deep sighing to extend the Qi. (Note: Worry and thought labor the Spirit, causing the Heart Connection to tighten. The Heart Connection links to the Lung, its meridian presses upon the Lung system, which is the passage for Qi in the throat. Since it is pressed, the Qi pathway is constrained and cannot pass, thus sighing deeply to extend the Qi. [Ping An]: In *Ling Shu* and *Jia Yi*, 'shen' is written as 'shen'.) Treatment should involve supplementing the Hand Shaoyin (Heart) and Xin Zhu (Pericardium) meridians, and retaining the needle in the Foot Shaoyang (Gallbladder) meridian. (Hand Shaoyin and Hand Jueyin Xin Zhu are both Heart meridians. Foot Shaoyang is the Gallbladder meridian. Because the tight Heart Connection draws upon the Liver and Gallbladder, both Yin meridians and one Yang meridian require needle retention to relieve tension.)

Huang Di said: "What qi causes drooling (xian xia)?" Qi Bo said: "Food and drink enter the Stomach. If there is Heat in the Stomach, Heat causes worms to move; when worms move, the Stomach relaxes; when the Stomach relaxes, the Lian Quan point opens, thus causing drooling. (Note: Worms refer to grain worms in the Stomach. Lian Quan is the aperture under the tongue, connecting the salivary pathway. If the Spirit is guarded, the pathway does not open; if stimulated by delicious flavors, the Spirit loses its guard, and the aperture opens, causing saliva to flow. It is also due to Stomach Heat moving worms, causing Lian Quan to open and saliva to flow. [Ping An]: In *Jia Yi*, 'xian' is written as 'HT'.) Treatment should involve supplementing the Foot Shaoyin (Kidney) meridian. (The Kidney Foot Shaoyin meridian runs alongside the base of the tongue and governs saliva and fluids; now it is deficient, hence drooling.)

Huang Di said: "What qi causes tinnitus (ear ringing)?" Qi Bo said: "The Ear is the gathering place of the Zong Mai (Major Meridians). Therefore, if the Stomach is empty, the Zong Mai become deficient; deficiency leads to sinking, and the flowing meridians become exhausted, thus causing tinnitus. (Note: Five collaterals—Foot Shaoyang, Taiyang, Hand Shaoyang, etc.—enter the ear, hence called the gathering of Zong Mai. Liu Mai refers to the meridians flowing into the ear. Exhaustion and blockage due to deficiency cause tinnitus.) Treatment should involve supplementing the Keyuzhuren point and the location where the Hand Large Intestine meridian meets flesh near the nail of the thumb. (Hand Yangming enters the ear, passing through Keyuzhuren. The Hand Taiyin meridian near the nail of the thumb is interior to Hand Yangming. Since both Yin and Yang are deficient, causing tinnitus, both are supplemented. [Ping An]: *Jia Yi* omits the character 'zhua'.)

Huang Di said: "What qi causes a person to bite their own tongue?" Qi Bo said: "This is due to Jue Ni (Rebellious Qi) ascending, with pulse Qi arriving in clusters. (Note: Bei means category/class. Rebellious Qi ascends to the head, so at places where class-like pulses arrive in the head, one bites the tongue. [Ping An]: In *Jia Yi*, '𠯑' is written as 'nie', and 'bei' as 'jie'.) When Shaoyin Qi arrives, the tongue is bitten; when Shaoyang Qi arrives, the cheek is bitten; when Yangming Qi arrives, the lip is bitten. Observe the primary diseased meridian and supplement it. (When Kidney Foot Shaoyin meridian Jue Ni reaches under the tongue, the tongue is bitten. When Hand and Foot Shaoyang meridians Jue Ni reach the cheek, the cheek is bitten. When Hand and Foot Yangming meridians Jue Ni reach the lip, the lip is bitten. These various meridians suffer from deficiency and Jue Ni, so observe the diseased meridian and supplement it.)

All these twelve pathogenic factors are odd pathogens invading the empty orifices. Therefore, wherever the pathogen resides, it is due to insufficiency. (Note: These twelve pathogens all cause deficiency, hence called odd pathogens. Kong Qiao refers to acupoints/orifices. Wherever this pathogenic Qi arrives, it damages Righteous Qi, thus causing illness through insufficiency. [Ping An]: In *Jia Yi*, 'shi er' is written as 'shi si'.) Therefore, when Upper Qi is insufficient, the Brain feels empty, the ears ring easily, the head tilts, and the eyes dim; (Note: The Head is Upper. When pathogenic Qi reaches the Head, there is tinnitus, the head cannot remain upright, and vision is dim. [Ping An]: In *Ling Shu*, 'shan ming' is written as 'ku ming', 'qing' has 'ku' before it, and 'ming' is written as 'xuan'.) When Middle Qi is insufficient, urination and defecation change, and the intestines rumble; (Note: Intestines and Bladder constitute Middle. When pathogenic Qi reaches Middle, the color of urine and stool changes abnormally, and there is intestinal rumbling. [Ping An]: In *Ling Shu*, 'xi' is written as 'ku'; in *Jia Yi* and Yuan edition, it is written as 'shan'.) When Lower Qi is insufficient, there is Wei syndrome (flaccidity), Jue syndrome (cold extremities), and leg stuffiness; treatment should involve supplementing below the outer ankle and retaining the needle. (Note: When pathogenic Qi reaches the Feet, there is flaccidity, Jue, dan-laxity, and leg stuffiness; one can supplement below the outer ankle. Another version says prick two cun above the web between the big toe and retain the needle. [Ping An]: In *Ling Shu*, 'wei' has 'nai' before it, 'zu men' is written as 'xin', and *Jia Yi* writes 'xin men'. Under 'ji', it says 'prick two cun above the big toe web and retain needle', which appears later in this book.)

Huang Di said: "How to treat them?" Qi Bo said: "For Yawning governed by the Kidney, take the Foot Shaoyin meridian. For Hiccups governed by the Lung, take the Hand Taiyin and Foot Shaoyin meridians. For Sobbing, where Yin and Yang are severed, supplement Foot Taiyang and reduce Foot Shaoyin. For Shivering Cold, supplement all Yang meridians. For Belching, supplement Foot Taiyin and Yangming. For Sneezing, supplement Foot Taiyang and Meiben. For Laxity, supplement the intermuscular spaces at the site. For Tearing, supplement the Tian Zhu Jing alongside the Neck; Xia Xiang Zhe refers to the midline of the Head. ([Ping An]: In *Ling Shu*, 'xiang' is written as 'jing'.) For Deep Sighing, supplement Hand Shaoyin, Xin Zhu, and retain needle in Foot Shaoyang. For Drooling, supplement Foot Shaoyin. For Tinnitus, supplement Keyuzhuren and the junction of flesh and nail on the thumb. For Biting Cheek, ([Ping An]: In *Ling Shu*, 'jia' is written as 'she'.) Observe the primary diseased meridian and supplement it. For Dizziness and Stiff Neck, supplement below the outer ankle and retain needle. For Flaccidity, Jue, and Leg Stuffiness, prick two cun above the web of the big toe and retain needle, or alternatively, supplement below the outer ankle and retain needle. (The following details treatment formulas. Regarding 'giving Yang', if Yin is abundant and unceasing, it cannot be reduced; do not say 'give', it can be considered abundant. 'Midline of the Head' refers to taking the division of Zong Mai traveling in the Head. Dan and Wei Jue are the same disease with different names; this text trusts this account. [Ping An]: In *Ling Shu*, 'mu ming xiang qiang' is written as 'mu xuan tou qing', 'bu' is added before 'zu', and 'zu men' is written as 'xin 𢻮'.)